We have made so many mistakes over the last 20 years with billing. Now, I look at it as a profit center in the business. My wife probably doubles our income.
There is money falling between the cracks so we have to decide whether it is cost effective to get it. Primary, secondary, patient remainders, it all takes continuous quality improvement to stay profitable.
If your spouse is involved, use them for auditing, supervision, troubleshooting, and the highest value/time functions and hire help for the repetitive stuff.